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Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease
Open accessAbstract
Background Although recommended in guidelines for the management of coronary heart disease (CHD), concerns have been raised about the applicability of evidence from existing meta-analyses of exercise-based cardiac rehabilitation (CR).Objectives The goal of this study is to update the Cochrane systematic review and meta-analysis of exercise-based CR for CHD.Methods The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Science Citation Index Expanded were searched to July 2014. Retrieved papers, systematic reviews, and trial registries were hand-searched. We included randomized controlled trials with at least 6 months of follow-up, comparing CR to no-exercise controls following myocardial infarction or revascularization, or with a diagnosis of angina pectoris or CHD defined by angiography. Two authors screened titles for inclusion, extracted data, and assessed risk of bias. Studies were pooled using random effects meta-analysis, and stratified analyses were undertaken to examine potential treatment effect modifiers.Results A total of 63 studies with 14,486 participants with median follow-up of 12 months were included. Overall, CR led to a reduction in cardiovascular mortality (relative risk: 0.74; 95% confidence interval: 0.64 to 0.86) and the risk of hospital admissions (relative risk: 0.82; 95% confidence interval: 0.70 to 0.96). There was no significant effect on total mortality, myocardial infarction, or revascularization. The majority of studies (14 of 20) showed higher levels of health-related quality of life in 1 or more domains following exercise-based CR compared with control subjects.Conclusions This study confirms that exercise-based CR reduces cardiovascular mortality and provides important data showing reductions in hospital admissions and improvements in quality of life. These benefits appear to be consistent across patients and intervention types and were independent of study quality, setting, and publication date.
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“Several Cochrane systematic reviews have demonstrated the utility of outpatient phase II CR to reduce mortality and hospital readmissions and to improve QOL.155”
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“Prescribed exercise is a fundamental component in the rehabilitation and treatment of numerous health conditions.”
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Metadata
- Authors
- Anderson, L., Oldridge, N., Thompson, D. R., Zwisler, A.-D., Rees, K., Martin, N., & Taylor, R. S.
- Affiliations
- University of Exeter (GB)
- University of Wisconsin–Milwaukee (US)
- Australian Catholic University (AU)
- University of Southern Denmark (DK)
- University of Warwick (GB)
- London School of Hygiene & Tropical Medicine (GB)
- Corresponding author
- Taylor, Rod S.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2016-01
- Volume
- 67
- Issue
- 1
- Pages
- 1-12
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2224950676
- Cited by
- 1,910
- References
- 57
- Citations by year
- 2026: 111 · 2025: 135 · 2024: 149 · 2023: 168 · 2022: 204 · 2021: 259 · 2020: 264 · 2019: 231 · 2018: 170 · 2017: 156 · 2016: 58
- FWCI
- 167.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion, other-oa)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Funders
- Royal Devon and Exeter NHS Foundation Trust
- University Hospitals Birmingham NHS Foundation Trust
- National Institute for Health and Care Research (RP-DG-0709-10111, RP-PG-0611-12004, NF-SI-0514-10155, RP-PG-1210-12004)
- University of Exeter
- Programme Grants for Applied Research
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- exercise-based cardiac rehabilitation, coronary artery disease, cardiovascular mortality, hospitalization, health-related quality of life, myocardial infarction, revascularization, angina pectoris, exercise therapy
- MeSH terms
- Coronary Disease, Humans, Quality of Life, Exercise, Treatment Outcome
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